Gao YL, Li HN, Wang Q, Shen W. Value of high-resolution magnetic resonance imaging and dynamic contrast-enhanced scanning in the preoperative diagnosis of rectal cancer in older patients. World J Gastrointest Surg 2025; 17(11): 109543 [DOI: 10.4240/wjgs.v17.i11.109543]
Corresponding Author of This Article
Wen Shen, DM, Professor, Department of Radiology, Tianjin First Central Hospital, No. 2 Baoshan West Road, Tianjin 300000, China. shenwen66@126.com
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Medicine, General & Internal
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 27, 2025 (publication date) through Nov 25, 2025
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World Journal of Gastrointestinal Surgery
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Gao YL, Li HN, Wang Q, Shen W. Value of high-resolution magnetic resonance imaging and dynamic contrast-enhanced scanning in the preoperative diagnosis of rectal cancer in older patients. World J Gastrointest Surg 2025; 17(11): 109543 [DOI: 10.4240/wjgs.v17.i11.109543]
World J Gastrointest Surg. Nov 27, 2025; 17(11): 109543 Published online Nov 27, 2025. doi: 10.4240/wjgs.v17.i11.109543
Value of high-resolution magnetic resonance imaging and dynamic contrast-enhanced scanning in the preoperative diagnosis of rectal cancer in older patients
Yan-Lei Gao, Hui-Na Li, Qiang Wang, Wen Shen
Yan-Lei Gao, The First Central Clinical School, Tianjin Medical University, Tianjin 300000, China
Hui-Na Li, Department of Pathology, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang 050000, Hebei Province, China
Qiang Wang, Department of Radiology, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang 050000, Hebei Province, China
Wen Shen, Department of Radiology, Tianjin First Central Hospital, Tianjin 300000, China
Author contributions: Gao YL and Shen W designed the research study; Gao YL, Li HN and Wang Q performed the research; Li HN collected and analyzed the data; Gao YL and Wang Q has been involved in drafting the manuscript and all authors have been involved in revising it critically for important intellectual content; all authors give final approval of the version to be published and have participated sufficiently in the work to take public responsibility for appropriate portions of the content and agreed to be accountable for all aspects of the work in ensuring that questions related to its accuracy or integrity.
Supported by Tianjin Key Medical Discipline (Specialty) Construction Project, No. TJYXZDXK-3-012B.
Institutional review board statement: The study was reviewed and approved by Shijiazhuang Maternal and Child Health Hospital, approve number: 20201110.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at shenwen66@126.com. Participants gave informed consent for data sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen Shen, DM, Professor, Department of Radiology, Tianjin First Central Hospital, No. 2 Baoshan West Road, Tianjin 300000, China. shenwen66@126.com
Received: July 4, 2025 Revised: August 12, 2025 Accepted: October 10, 2025 Published online: November 27, 2025 Processing time: 143 Days and 19.8 Hours
Abstract
BACKGROUND
Rectal cancer is a common malignant tumor of the digestive system, with older patients representing the predominantly affected population. Magnetic resonance imaging (MRI) has been widely applied in preoperative tumor assessment; however, the value of high-resolution MRI (HR-MRI) combined with dynamic contrast-enhanced (DCE) scanning in the preoperative diagnosis of rectal cancer in older patients remains unclear.
AIM
To evaluate the value of HR-MRI combined with DCE scanning in the preoperative diagnosis of rectal cancer in older patients.
METHODS
This retrospective study included 148 consecutive older female patients with rectal cancer who were treated at our hospital between December 2020 and December 2024. Clinical data and HR-MRI and DCE scan findings were collected. Histopathological examination after surgical resection served as the gold standard. The diagnostic accuracy of MRI for preoperative T and N staging was calculated. Consistency, sensitivity, and specificity between HR-MRI combined with DCE scanning and pathological staging were analyzed using the k test.
RESULTS
Among the 148 patients, the overall accuracy of T staging was 84.5%. Sensitivity for T1, T2, T3, and T4 staging was 75.00%, 62.50%, 89.47%, and 90.48%, respectively, whereas specificity was 100.00%, 94.35%, 79.25%, and 96.06%, respectively. T staging based on HR-MRI combined with DCE scanning showed good agreement with pathological staging (k = 0.8176, P < 0.001). For N staging, sensitivity and specificity were 54.88% and 84.85% for N0, 36.96% and 72.55% for N1, and 70.00% and 73.44% for N2, respectively; agreement with pathological N staging was poor (k = 0.259, P < 0.001).
CONCLUSION
HR-MRI combined with DCE scanning demonstrates high diagnostic accuracy for T staging of rectal cancer in older patients and can provide a theoretical basis for treatment planning. However, its diagnostic accuracy for N staging requires improvement.
Core Tip: This study evaluated the value of high-resolution magnetic resonance imaging combined with dynamic contrast-enhanced scanning for preoperative staging of rectal cancer in older patients. In a retrospective analysis of 148 patients (December 2020 to December 2024), postoperative histopathology served as the gold standard. T staging accuracy was 84.5%, with a sensitivity of 62.5%-90.5% and specificity of 79.3%-100% across T1-T4 stages, demonstrating excellent agreement with pathological staging (k = 0.817, P < 0.001). Conversely, N staging showed lower sensitivity (36.96%-70.0%) and specificity (72.55%-84.85%), with poor agreement (k = 0.259, P < 0.001). Overall, this combined imaging approach provides high diagnostic accuracy for T staging to guide treatment planning, although its performance in N staging requires improvement.
